Background: The Outcome Measures in Rheumatology (OMERACT) initiative developed a core outcome set (COS) of domains to assess effectiveness of interventions for knee osteoarthritis. These domains (pain, physical function, patient global assessment, imaging at 1 year) should be assessed in every trial to make research evidence meaningful and comparable. We systematically evaluated and critically appraised the use of measurement instruments and outcome domains in prospective studies evaluating patients with knee osteoarthritis undergoing total knee arthroplasty (TKA) and assessed their accordance with the OMERACT COS.
Methods: Literature search was performed until August 26, 2014, in Medline and Embase. Clinical trials and prospective observational studies with =50 participants and a follow-up of =1 year were included. We collected general study characteristics, comprehensive information on measurement instruments, and corresponding domains used.
Results: This systematic review identified low accordance of used outcome domains with the OMERACT COS of domains published in 1997. Only 4 of 100 included studies included all recommended core domains. Pain (85% of studies) and physical function (86%) were assessed frequently, whereas patient global assessment (21%) and joint imaging (=1 year; 27%) were rarely assessed. There was substantial heterogeneity in the use of measurement instruments (n = 111) investigating TKA.
Conclusion: More efforts are required to implement the existing COS. In addition, a more consistent use of adequate measurement instruments is important to make research evidence on TKA more relevant, better comparable, and thus more useful for guideline developers and clinical decision makers.
The aim was to conduct a systematic review of recently published trials and prospective cohort studies evaluating patients with knee OA undergoing TKA to evaluate and critically appraise the use of outcome domains and measurement instruments and to assess their accordance with the OMERACT core set of outcome domains
ContributorsToni Lange, Elisabeth Rataj, Christian Kopkow, Jörg Lützner, Klaus-Peter Günther, Jochen Schmitt
Disease Category: Rheumatology
Disease Name: Knee Osteoarthritis
Age Range: Unknown
Sex: Either
Nature of Intervention: Surgery
- COS uptake study
- Systematic review
The systematic literature search was performed until August 26, 2014, in Medline and Embase, using the Ovid interface. Aiming to critically appraise the current evidence, we decided to screen the 1.000 most recently published studies yielded by systematic literature
search. Clinical trials (RCTs) and prospective observational studies (cohort studies, registry studies) with a minimum of 50 participants and a follow-up of at least 1 year investigating TKA for knee OA in at least 1 intervention/study group were included. Studies were only
included if outcomes (study end points) were defined and measurement instruments for those outcomes were named and specified. Studies were excluded if more than 20% of included patients received a revision surgery, if more than 20% of included patients
received unicondylar knee arthroplasty, or if TKA was performed due to trauma or tumor. Furthermore, studies not written in English or German language were excluded.